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Treatment delay and reliance on private physicians among patients with sexually transmitted diseases in China.

Abstract：

:We examined health-care seeking practices among patients with sexually transmitted diseases (STDs) in south China. In 1995, we recruited a consecutive sample of 939 STD patients attending the STD clinics of the Municipal STD Control Centers of Guangzhou and Shenzhen, 'special economic zones' near Hong Kong. Attending physicians interviewed patients face-to-face using a standard survey questionnaire. Twenty-seven per cent of all subjects had sought treatment elsewhere for their presenting complaints, before visiting a study clinic. The main sources of prior treatment were private physicians followed by public clinics and drugstores. Women were more likely than men to delay in presenting their current symptoms to a study clinic (32% vs 25%, P=0.046). Factors associated with treatment delay differed by gender. Among men, seeking prior treatment from private physicians (OR=3.31; 95% CI=1.70, 6.43), having no urethral discharge (OR=4.00; 95% CI=2.33, 6.85), having engaged in sex trade (OR=1.64; 95% CI=1.03, 2.63), or being a resident in Shenzhen (OR=1.80; 95% CI=1.12, 2.89) were more likely to delay seeking treatment. Among women, only living in Shenzhen (OR=2.86; 95% CI=1.56, 5.25) was associated with treatment delay. Promotion of appropriate health-seeking behaviours and better management of STDs must be a top priority to slow a rapid spread of STD/HIV in China. Health education, improvement of STD care in the public and private sectors, and regulations of unauthorized private physicians, may help with STD control and HIV prevention. :Sexually transmitted diseases (STD) have re-emerged as a public health concern in China since the early 1980s, as a phenomenon associated with rapid economic liberalization. The rapid increase in STDs is especially alarming in the country's special economic zones. The health-care seeking practices of patients with STDs in south China were examined. In 1995, a consecutive sample of 939 STD patients attending the STD clinics of the Municipal STD Control Centers of Guangzhou and Shenzhen, special economic zones near Hong Kong, was recruited for face-to-face interviews by their attending physicians. 27% of all subjects had sought treatment elsewhere for their presenting complaints before visiting the study clinic. The main sources of prior treatment were private physicians, followed by public clinics and drugstores. Women were more likely than men to delay seeking care from a study clinic (32% versus 25%). Among men, seeking prior treatment from private physicians, having no urethral discharge, having engaged in sex trade, and residence in Shenzhen were predictive of a likelihood to delay seeking treatment. Among women, only residence in Shenzhen was associated with treatment delay. The promotion of appropriate health-seeking behaviors and the improved management of STDs should be given priority attention in an effort to slow the spread of HIV/STD in China.

journal_name

Int J STD AIDS

journal_title

International journal of STD & AIDS

authors

Choi KH,Zheng X,Zhou H,Chen W,Mandel J

doi

10.1258/0956462991914177

subject

Has Abstract

pub_date

1999-05-01 00:00:00

pages

309-15

issue

eissn

0956-4624

issn

1758-1052

journal_volume

pub_type

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Treatment delay and reliance on private physicians among patients with sexually transmitted diseases in China.